Temporomandibular Joint Dysfunction (TMJ)
Synonyms of Temporomandibular Joint Dysfunction (TMJ)
- Costes Syndrome
- Impostor Disease
- Myofascial Pain-Dysfunction Syndrome
- Pain-Dysfunction Syndrome
- Temporomandibular Joint Syndrome
- No subdivisions found.
Temporomandibular joint (TMJ) dysfunction is a general term for a group of conditions that affect the temporomandibular joint. The TMJs are small joints that connect the lower jaw (mandible) to the temporal bone of the skull. TMJ dysfunction is characterized by pain of the jaw joint that is made worse during or after eating or yawning. It can cause limited jaw movement and clicks and pops during chewing. In severe cases, pain can radiate into the neck, shoulders and back.
TMJ dysfunction is characterized by pain affecting the jaws. The pain may also involve the eyes, ears, teeth, head, neck, shoulders and back. Sometimes there is ringing in the ears (tinnitus), dizziness and loss of equilibrium. Difficulties of movement in the jaw can result in swallowing and chewing problems. About 85 percent of affected individuals feel pain on only one side usually in the temple, cheek, and front of the ear. The pain may be constant or come and go.
In some cases, the jaw may lock in an open or closed position. Affected individuals may also experience swelling on one side of the face, painful clicking, popping or grating when opening or closing the mouth (e.g., when chewing), an inability to open the mouth fully or comfortably, repeated headaches, earaches (otalgia), and hearing problems. Some affected individuals may experience a sudden change in the way the upper and lower teeth meet (malocclusion).
There are many suspected causes of TMJ dysfunction. The only definite cause is trauma to the jaw as from a heavy blow to the mouth. For example, jawbone dislocation from a blow during a car accident or fall may cause TMJ dysfunction. The jaw joint can be dislocated without force from outside the body (e.g., from strained opening of the mouth).
TMJ dysfunction may also occur secondary to myofascial pain dysfunction (MPD) syndrome or due to internal damage to the temporomandibular joint (true articular disease). MPD syndrome affects the chewing muscles. Muscle spasms, often caused by grinding the teeth, create facial pain that may spread to nearby muscles.
True articular disease may result from degenerative joint disease (osteoarthritis), systemic arthritis conditions, fibrous ankylosis, infections, or dislocation or displacement of the jaw.
Degenerative joint disease may cause cartilage-like tissues wear away from the jaw joint. This alters movement and creates a crackling sound when the jaw moves. Inflammatory joint disorders occur when membranes on the sides of the disk become inflamed due to rheumatoid arthritis. Chronic restricted jaw movement such as fibrous ankylosis, occurs when fibrous tissue forms in the joint reducing jaw movement. Left untreated it can "freeze" the jaw. Joint growth disorders cause the jawbone to continue to enlarge after growth should have stopped. This causes the bite and joint movements to become abnormal.
Functional causes of TMJ dysfunction include breakdown of the support provided by the teeth or most commonly grinding of the teeth (bruxism).
TMJ dysfunction is a common condition of adulthood that affects females three times more often than males. It is most common in women ages fifteen to forty-four. People between the ages of 30-50 are most often affected.
Symptoms of the following disorders can be similar to those of TMJ dysfunction. Comparisons may be useful for a differential diagnosis:
Rheumatoid arthritis is an inflammatory autoimmune disease in which the body's natural defenses against foreign agents (antibodies & lymphocytes) attack healthy joints. This disorder is characterized by a lack of appetite, fatigue, painful and deformed joints, early morning stiffness chiefly in the hands, knees, feet, jaw and spine. (For more information on this disorder, choose "rheumatoid arthritis" as your search term in the Rare Disease Database.)
Tinnitus is the perception of sound such as a ringing in the ears, in the absence of an actual sound. The disorder may be caused by a variety of ear problems including obstruction, infections, Meniere's disease, certain medications and head injuries. (For more information on this disorder, choose "Tinnitus " as your search term in the Rare Disease Database.)
Tetanus is an infectious disease marked by painful muscular contractions caused by the toxin tetanospasmin, acting upon the central nervous system. Tetanus can cause "Lockjaw" which freezes the jaw into a locked position.
A diagnosis of TMJ dysfunction may be made based upon a thorough clinical evaluation, a detailed patient history, identification of characteristic findings, and certain x-ray tests that show the condition and shape of the jaw.
Treatment of TMJ dysfunction varies according to the individual person's needs. Many affected individuals will only require conservative treatment including the application of heat or cold (e.g., heating pads or icepacks), eating soft foods, and special exercises to stretch or relax facial muscles. Anti-inflammatory drugs may be prescribed in some cases.
In some cases, a bite plate may be used to treat TMJ dysfunction. A bite plate is a device that repositions or relaxes the jaw and muscles and reduces pressure on teeth and jaw joints. If TMJ results from grinding of the teeth, these plastic devices often alleviate the problem. Some people wear the bite plates at night when grinding of the teeth cannot be consciously avoided. Treatment of muscle spasms may include relaxant drugs such as diazepam and analgesics for pain. Physical therapy, splints, permanent jaw adjustments or corrective dental work are also sometimes necessary.
Doctors at the National Institutes of Health (NIH) are conducting a clinical trial on Temporomandibular Joint Dysfunction. For more information, contact:
Building 10 Room 1N103
10 Center Dr
Bethesda, MD 20892
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
Organizations related to Temporomandibular Joint Dysfunction (TMJ)
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Uyanik JM, Murphy E. Evaluation and management of TMDs, Part 1. History, Epidemiology, classification, anatomy, and patient evaluation. Dent Today. 2003;22:140-5.
Tuz HH, Onder EM, Kisnisci RS. Prevalence of otologic complaints in patients with temporomandibular disorder. Am J Orthod Dentofacial Orthop. 2003;123:620-3.
Siegmund T, Harzer W. Orthodontic diagnostics and treatment planning in adults with temporomandibular disorders a case report. J Orofac Orthop. 2002;63:435-45.
Vincent SD, et al. Incidence and characterizations of temporomandibular joint sounds in adults. J Am Dent Assoc. 1988;116:203-6.
Weinberg S, et al. Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint. J Oral Maxillofac Surg. 1987;45:653-6.
Gay T, et al. The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg. 1987;45:397-407.
FROM THE INTERNET
National Institute of Dental and Craniofacial Research. TMD: Temporomandibular Disorders. Available at: http://www.nidcr.nih.gov/HealthInformation/OralHealthInformationIndex/TMDTMJ/Tmd.htm Accessed On: March 27, 2005.
Chaudary A. Temporomandibular Joint Syndrome. eMedicine Journal. 2002;3:11pp. Available at: http://www.emedicine.com/neuro/topic366.htm Accessed On: March 27, 2005.
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